Office for National Statistics Data (ONS)

  • Poisonings involving some prescription and other opioids used to treat pain increased dramatically in 2014 but this is thought to be, in part, a factor of how the data is reported
  • Changes in deaths from one year to the next are unreliable for detecting trends, which relies on longer-term analysis
  • There is an underlying pattern of increasing deaths in which an opioid pain medicine (OPM), especially tramadol, is mentioned as present on the death certificate. In the latest data set, deaths related to tramadol have risen to 240 per annum.
  • Deaths have largely mirrored prescribing levels but in recent years there have been some significant increase in rates of death per prescription
  • Available data only reports on substances “mentioned” on death certificates – it is unable to distinguish deaths caused by the substance or substances and those where the substance is present but did not contribute to the death, and does not identify whether the substance was legitimately obtained on prescription or over-the-counter or obtained illicitly.
  • Not all substances are tested for in post-mortem toxicology. There is variability both across the coronal system and over time as to which substances are tested for and how their contribution to a death is interpreted.

The Office for National Statistics (ONS) publishes annual data on drug poisoning and drug misuse deaths. It does not distinguish between prescribed, over-the-counter and illicitly-obtained medicines. The drug misuse figures only include drugs controlled under the Misuse of Drugs Act but, as additional drugs are controlled under the Act, the data is  backdated. The published data only breaks down poisoning (and not drug misuse) deaths by substance so it is data on these poisoning deaths that is presented here.

ONS figures are based on deaths registered (rather than occurring) in a particular calendar year. Many deaths involving poisoning (especially those involving drug misuse) will be investigated by the coroner so may not be registered until some time after they occurred.
Significant rises in 2013 and 2014 are thought to result, in part, from changes in reporting by coroners.



Further Reading

  • Office for National Statistics: Deaths related to drug poisoning in England and Wales. 2014. 
  • Novak SP, Håkansson, Martinez-Raga J, et al. Nonmedical use of prescription drugs in the European Union. BMC Psychiatry 2016; 16: 274.